ArticleRevista brasileira de epidemiologia = Brazilian journal of epidemiology2026
Use of public and private oral health services by Brazilian adults from 2003 to 2023: trends and socioeconomic inequalities.
Article in Revista brasileira de epidemiologia = Brazilian journal of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo analyze socioeconomic inequalities in the use of oral health services among Brazilian adults aged 35-44 years between 2003 and 2023, according to level of education, income, and type of service used.
methodsThis is a cross-sectional study on data from the National Survey of Oral Health (SB Brasil) 2003, 2010, and 2023. Weighted prevalences of the use of oral health services in the previous year were estimated, and absolute (Slope Index of Inequality - SII) and relative (Relative Index of Inequality - RII) measures of inequality were calculated according to level of education and income. Multiple logistic regression models were used to assess the association between socioeconomic indicators and service use.
resultsBetween 2003 and 2023, the proportion of adults who used oral health services in the previous year increased from 38.7 to 51.6%. The RII for level of education decreased from 2.16 to 1.39, and the SII, from 0.30 to 0.20, indicating a reduction in educational inequalities, statistically significant among public service users (RII=1.08; SII=0.07 in 2023). Income-related inequalities remained unchanged. According to adjusted models, there was a significant interaction between level of education and type of service, with a steeper gradient in the private sector and a more homogeneous pattern in the public sector.
conclusionFrom 2003 to 2023, the use of oral health services increased, and educational inequalities declined among users of public services, reflecting progress in the consolidation of the National Oral Health Policy and in the expansion of public access. However, economic disparities persist, underscoring the need for redistributive policies that integrate equity and sustainability in the financing of the Brazilian Unified Health System.
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